Abstract
Abstract
Many Danish hospitals have a leadership structure that has several groups of health professionals represented both at top management level and at departmental level. Solving appropriately distributed tasks, the two largest professions – doctors and nurses – therefore play a significant role in the multidisciplinary leadership efforts to make decisions that control and affect areas such as financial allocation, staffing and professional development.
Taking the perspectives of social analysis and conflict theory, this thesis explores how we can interpret the respective roles, or positions, of nursing and medical heads of departments in the field of medicine. It also takes a closer look at the power struggles and conflicts of interest that exist between leading health professionals at a large Danish university hospital.
The thesis also seeks to determine the basic values constituting the backdrop of the nurses’ and doctors’ differing practice styles. Moreover, it applies an analysis of the management context to clarify the conditions under which leadership takes place.
The aim of this thesis is twofold: firstly, to contribute to the existing body of knowledge about professionals in management roles: and secondly, to shed light on social, organizational and profession-related issues that can help to explain why the tradition of positioning is maintained and perpetuated within the field of medicine.
The findings presented here are results from a case study based on two focus-group interviews and document analysis. The empirical data has been subject to analysis using Pierre Bourdieu’s concepts of field, capital and habitus. By applying his three steps of field analysis – placing the medical field in relation to the super ordinate power field of national authority; mapping the objective relations between the participating players; and analyzing the players’ habitus and their varying levels of influence within the field – I arrive at answers to the questions posed in the basic wording of my thesis question. The analysis findings are further qualified by incorporating different angles of profession sociology: that set out by Talcott Parsons in his functionalistic profession sociology; and that of Max Weber’s critical profession sociology.
The conclusion is that management at the hospital where my study took place is founded on a social ideology that springs from a neo-liberalist control rationale and is based upon New Public Management (NPM).
The study also concludes that medical and nursing heads of department take on different types of management projects. The head doctors mainly give priority to profession-based leadership, whereas the head nurses view management in a broader perspective and incorporate more dimensions into their thinking. Surprisingly, the analyses in the thesis show that head doctors to some degree feel threatened by head nurses, who are apparently more skilled at acting within the NPM framework than the doctors themselves are.
Furthermore the thesis analyses suggest that, compared with nurses, doctors possess the greater amount of symbolic capital – which endows them with power and prestige – and therefore hold the dominant position in the health-care field. Nurses attempt to achieve the same recognition as doctors by means of professionalization, but they are in a professional identity crisis. This causes them to experience a conflict between that which nurses, among themselves, regard as the “core of the profession”, on the one hand, and the strategy of increasing their levels of academic and professional performance, on the other.
Many Danish hospitals have a leadership structure that has several groups of health professionals represented both at top management level and at departmental level. Solving appropriately distributed tasks, the two largest professions – doctors and nurses – therefore play a significant role in the multidisciplinary leadership efforts to make decisions that control and affect areas such as financial allocation, staffing and professional development.
Taking the perspectives of social analysis and conflict theory, this thesis explores how we can interpret the respective roles, or positions, of nursing and medical heads of departments in the field of medicine. It also takes a closer look at the power struggles and conflicts of interest that exist between leading health professionals at a large Danish university hospital.
The thesis also seeks to determine the basic values constituting the backdrop of the nurses’ and doctors’ differing practice styles. Moreover, it applies an analysis of the management context to clarify the conditions under which leadership takes place.
The aim of this thesis is twofold: firstly, to contribute to the existing body of knowledge about professionals in management roles: and secondly, to shed light on social, organizational and profession-related issues that can help to explain why the tradition of positioning is maintained and perpetuated within the field of medicine.
The findings presented here are results from a case study based on two focus-group interviews and document analysis. The empirical data has been subject to analysis using Pierre Bourdieu’s concepts of field, capital and habitus. By applying his three steps of field analysis – placing the medical field in relation to the super ordinate power field of national authority; mapping the objective relations between the participating players; and analyzing the players’ habitus and their varying levels of influence within the field – I arrive at answers to the questions posed in the basic wording of my thesis question. The analysis findings are further qualified by incorporating different angles of profession sociology: that set out by Talcott Parsons in his functionalistic profession sociology; and that of Max Weber’s critical profession sociology.
The conclusion is that management at the hospital where my study took place is founded on a social ideology that springs from a neo-liberalist control rationale and is based upon New Public Management (NPM).
The study also concludes that medical and nursing heads of department take on different types of management projects. The head doctors mainly give priority to profession-based leadership, whereas the head nurses view management in a broader perspective and incorporate more dimensions into their thinking. Surprisingly, the analyses in the thesis show that head doctors to some degree feel threatened by head nurses, who are apparently more skilled at acting within the NPM framework than the doctors themselves are.
Furthermore the thesis analyses suggest that, compared with nurses, doctors possess the greater amount of symbolic capital – which endows them with power and prestige – and therefore hold the dominant position in the health-care field. Nurses attempt to achieve the same recognition as doctors by means of professionalization, but they are in a professional identity crisis. This causes them to experience a conflict between that which nurses, among themselves, regard as the “core of the profession”, on the one hand, and the strategy of increasing their levels of academic and professional performance, on the other.
| Originalsprog | Dansk |
|---|---|
| Status | Udgivet - 2010 |